Because of high density, a 4.5x13 mm drill has to be used prior to placement of the same sized immediate implant (Fig.5).  For most of immediate implants, osteotomy should be under prep. 

The apical space (between arrowheads) is finally closed by seating the implant lower (Fig.6).

When he returns 2nd time (4.5 months postop), the implant appears to have osteointegrated (Fig.7).

Red dashed line: the Mental Nerve. 

Immediate Implant in Hard Bone Last Fig.6 Next

Xin Wei, DDS, PhD, MS 1st edition 09/03/2015, last revision 01/26/2019